Objective: Pulmonary hypertension (PH) is a prominent prognostic feature of heart failure (the final common pathway of most cardiovascular diseases (CVD)) and has limited epidemiological data in Africa. We sought to determine the differences in clinical and echocardiographic characteristics as well as outcomes with respect to gender in a cohort of patients with PH in Douala, Cameroon.

Design and Method: A prospective study from March 2012 to December 2013 in which PH patients were consecutively recruited following echocardiography (right ventricle systolic pressure (RVSP) ≥35 mmHg) from two cardiovascular centers in Douala. Patients were followed up for 12 months. Group comparisons were done using chi square & t-tests while survival was estimated using Kaplan-Meier plots and log rank tests for comparisons.

Results: In a cohort of 130 patients (54.6% women) with PH (78% being PH due to left heart disease) were recruited. Overall mean age was 58.7years (59.2 for men and 58.3 for women). While hypertension, cigarette smoking and alcohol abuse were more common in men than women (all p < 0.001), women had respectively greater exposure to log smoke (p < 0.001), previous pulmonary tuberculosis infection (p < 0.01) and S3 gallop rhythm (p < 0.01) than men. Echocardiographic left ventricle (LV) systolic dysfunction was found more in men (mean LV ejection fraction: 41.6 vs 51.5, p < 0.01 and mean fractional shortening: 21.4 vs 28.6, p < 0.01), while rheumatic valvular heart disease was frequent in women (p < 0.01). Overall mortality rate was 39.2% and survival was better in females.

Conclusions: Though women are more affected by PH, conventional cardiovascular risk factors were more common in men with PH as opposed to rheumatic valvulopathies in women. Interventions targeting control of CVDs in the region should be intensified while accounting for women's specificities.